CLEVELAND, Ohio – A newborn boy, who underwent a successful in utero procedure at University Hospitals Rainbow Babies & Children’s Hospital (UH Rainbow) at 24 weeks of gestation, was born full-term and discharged with his mother at just four days old. The Congenital Heart Collaborative, in conjunction with UH MacDonald Women’s Hospital, is the only program in Ohio to offer the in utero procedure known as Fetal Aortic Valvuloplasty.
“When I first met the family, their goal was to have a few hours to hold him before he passed away,” says James Strainic, MD, Director, Fetal Heart Program at UH Rainbow. “Having the opportunity to watch the parents bring in his car seat to go home without having to undergo any procedures, was a very humbling and emotional experience. We could not have asked for a better outcome.”
Fetal Aortic Valvuloplasty is a unique procedure that uses ultrasound guidance and a catheter-based approach to gain access to the fetal heart, subsequently opening the aortic valve using a tiny inflated balloon. This increases blood flow through the left ventricle of the heart to help its development and prevent the progression of hypoplastic left heart syndrome (HLHS).
Babies born with HLHS are sometimes referred to as having half a heart, because the left chambers of the heart are too small to pump blood to the body. Not only did this fetus have developing HLHS, but he also had severe leakage of another heart valve. Statistics show that babies with this combination of defects have a 10% chance of survival to 6 months of age.
Aimee K. Armstrong, MD, Director of Cardiac Catheterization and Interventional Therapies at Nationwide Children’s Hospital, built a team of experts from Nationwide Children’s, UH Rainbow and UH MacDonald Women’s hospitals, as part of the Congenital Heart Collaborative. The team has performed four of these rare procedures in just over a year.
“The goal of the minimally invasive fetal procedure is to attempt to reverse the developing HLHS and decrease the number of open heart surgeries for the child later in life,” said Dr. Armstrong. “In this recent case, the procedure completely reversed the evolving HLHS, in addition to the severe valve leakage, to the point that an open heart surgery may never be needed, which is the best possible outcome for him.”
The Congenital Heart Collaborative, formalized three years ago, is a partnership between UH Rainbow Babies & Children’s in Cleveland and Nationwide Children’s in Columbus, which brings together expert physicians, surgeons and teams to provide world class care for patients and families in Northeast Ohio.
With UH Rainbow Babies & Children’s and UH MacDonald Women’s hospitals both under one roof, Maternal Fetal Medicine specialists and the Congenital Heart Collaborative team can offer the full continuum of care in rare cases like this, for optimal outcomes.
“It is critical for expectant moms whose pregnancies aren’t routine – due to their own health condition or a congenital fetal diagnosis – that they deliver at a facility equipped to provide the highest level of care to both mom and baby,” said Ellie Ragsdale, MD, Director of Fetal Intervention, at UH MacDonald Women’s Hospital.
This baby boy is nearly one month of age, doing well at home, and will continue to receive care from experts at UH Rainbow and the Congenital Heart Collaborative.
To learn more about fetal heart care, visit: http://www.uhhospitals.org/rainbow/services/cardiology-cardiothoracic-surgery/cardiology/fetal-heart-program